Cytomegalovirus Retinitis in a Child with Acute Lymphoblastic Leukemia

Entisar H. A. L. Shammary; Ali Abdul Razzaq Mahmood Al-Mafrachi; Yacoub A. Yousef; Safa Faraj

doi:10.3889/oamjms.2022.9456

Authors

Entisar H. A. L. Shammary Consultant of Pediatrics and Hemato-oncologist, Child’s Central Teaching Hospital, Baghdad, Iraq
Ali Abdul Razzaq Mahmood Al-Mafrachi Consultant of Pediatrics and Ophthalmologist, Ibn AL Haitham Teaching Eye Hospital, Baghdad, Iraq
Yacoub A. Yousef Department of Surgery and Ophthalmology, King Hussein Cancer Center, Amman, Jordan https://orcid.org/0000-0002-4126-055X
Safa Faraj Department of Pediatrics, Faculty of Medicine, Wasit University, Kut, Iraq https://orcid.org/0000-0002-4126-055X

DOI:

https://doi.org/10.3889/oamjms.2022.9456

Keywords:

Leukemia, Immunocompromised, Maintenance phase, Cytomegalovirus retinitis

Abstract

BACKGROUND: Due to the reduced immune response following chemotherapy, cytomegalovirus (CMV) retinitis is the most prevalent opportunistic intraocular infection in HIV-infected adults. It can also affect children with acute lymphoblastic leukemia (ALL).

CASE PRESENTATION: We describe an 11.5-year-old female who is undergoing maintenance chemotherapy for B-lineage ALL. She had vision loss in her right eye and began to have hazy vision in her left eye. Bilateral active retinitis lesions were discovered during the retinal examination. The diagnosis of bilateral CMVR was made based on clinical symptoms, retinal examination findings, and a blood sample for CMV DNA detection using the polymerase chain reaction (PCR) technique. She was given ganciclovir intravenously and intravitreally, followed by oral valganciclovir prophylaxis. Patients who received a solid organ or hematopoietic stem cell transplant were infected with CMVR, although patients with ALL who received less immunosuppressive chemotherapy were also affected (maintenance phase therapy). Intravenous and intravitreal ganciclovir injections are effective treatments, the patient had significant clinical improvement. CMV retinitis is frequent in children with ALL who are in the maintenance phase of the treatment.

CONCLUSION: The importance of early detection and treatment cannot be overstated. CMV retinitis: Key prognostic variables. CMV retinitis should be considered as cause of blurred vision in patients with ALL.

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Author Biography

Safa Faraj, Department of Pediatrics, Faculty of Medicine, Wasit University, Kut, Iraq

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